Here & Now

American Rescue Plan’s Impact on Affordable Care Act

Frederica Freyberg:

As folks start talking about getting back to normal with the flood of COVID vaccine rushing into states, many people still look to getting back to even after job loss or reduction and with bills and debt piling up. One major worry for everyone, especially in the midst of a pandemic, is the cost and coverage of health care. There are some big changes that are part of the federal stimulus package which our next guest calls historic and significant. Bobby Peterson is executive director of ABC for Health, a nonprofit public interest law firm focused on health care access. Thanks a lot for being here again.

Bobby Peterson:

You’re welcome. Glad to help.

Frederica Freyberg:

So is what’s in the American Rescue Plan historic when it comes to health care and specifically the Affordable Care Act?

Bobby Peterson:

Absolutely. There were no changes made when the Affordable Care Act was passed ten years ago and there was a lot of call for adjustments and changes and helping to improve it, but nothing ever made it through. In fact, the opposite was occurring, where people were trying to repeal it.

Frederica Freyberg:

Right.

Bobby Peterson:

This is a giant step forward. It provides a lot of opportunities for additional coverage for people, support for people, premium payment support, tax subsidies. It’s a really big deal.

Frederica Freyberg:

So the open enrollment period for marketplace plan runs through May 15. What can people looking to sign up for coverage expect under the new provisions?

Bobby Peterson:

Well, I mean, if you have coverage, there’s opportunities to go in after April 1. The federally-facilitated marketplace is supposed to have the adjustments made. So you can identify some of the credits that may be available to you. You can switch insurance still if you find something that’s more affordable. For people that are below 150% of the federal poverty limit, cost sharings are going to go away at that point. And for a lot of those people that had a federal poverty limit above 400% where you kind of hit a cliff, where suddenly there was no advance premium tax credits available, some of those people will have opportunities for subsidized care. A lot of them will.

Frederica Freyberg:

What we’re saying is 150% of the federal poverty limit, I looked, it’s something like $19,000. And what you’re saying is that if that’s the kind of income you’re at, you could get, under these new provisions, a marketplace plan under the Affordable Care Act for zero premiums?

Bobby Peterson:

Correct. That’s for a family of one.

Frederica Freyberg:

Right.

Bobby Peterson:

It increases — the federal poverty level will change based upon your family size so the income will be significantly higher for a family of four for example. It’s an important change and it’s an important opportunity for people to get both subsidized health care coverage and to maintain continuity of coverage.

Frederica Freyberg:

Again, if you’re already enrolled in one of those plans, is it automatic that these kind of new monies accrue to your premiums or do you have to make some changes?

Bobby Peterson:

Well, I mean, we would advise you to go in and to make some of the adjustments after April 1. I mean, if you don’t do anything, you’ll be able to reconcile it on your taxes next year. But it’s a good idea if you want to take advantage of some of these opportunities early to go into the marketplace and make those changes if you need to.

Frederica Freyberg:

Okay. The federal stimulus money also incentivizes states to expand Medicaid. States like Wisconsin which has not done so. Our republican Assembly speaker saying he is opposed to that expansion. But what would be in it for Wisconsin to expand?

Bobby Peterson:

$1.6 billion. $1.6 billion. This is a significant chunk of change. When you think about the Medicaid program, resources coming into the state, what a great way to hit money across the state. Because every county in the state has people that are getting BadgerCare Plus Medicaid. Doctors, physicians, federally-qualified health centers. This will really provide a big shot in the arm for the patients that need it and for health care infrastructure in this state. It also frees up a lot of state GPR funds to rebuild our public health system, which we need to do. This pandemic has taught us that we were caught very flat-footed. And we need to make sure that we’re prepared and ready. Because this isn’t — you know, this is going to happen again at some point, unfortunately. And so I think using some of these resources to rebuild public health, to make sure that we’re in a better position than we were when the first pandemic hit.

Frederica Freyberg:

One reason Republican policymakers have been resistant to expanding Medicaid is that they worry that the program will be expanded and then the federal money won’t be renewed. We know some of these other enhancements last for two years. What about the concerns around that?

Bobby Peterson:

I mean, you know, I think that in a crisis situation like this you want to try and maximize federal money. I mean, Tommy Thompson used to say if federal money is available, you should take it. And I agree with that. It’s an opportunity here to address immediate needs. It’s an opportunity to make sure we get the care and coverage to the people who need it. And I think a very important — people talk about no coverage gaps, which is one of the arguments that is made. Coverage gaps are smaller in Wisconsin, but it’s like trying to work through a maze, trying to figure out the 30 plus features of Medicaid that you’re eligible for, all the different features of the Affordable Care Act. It’s hard for the average person to figure it out. We could simplify it. BadgerCare Plus separates parents from their children. The parents are directed to the marketplace. Kids are BadgerCare Plus. That’s an extra step that we don’t need.

Frederica Freyberg:

All right. We leave it there. There’s a lot more discussion around that issue for sure. Bobby Peterson, thanks very much.

Bobby Peterson:

Okay. Thanks, Fred.